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everett � ��,,,...';a;`�;,tM"'%'_',�� <br /> � = <br /> � ,. � <br /> � �� �-�-•'�, — � <br /> City of Everett <br /> Engineering Department <br /> Sewe� Application and Permit <br /> NO. 2,. 3 G � DATE <br /> Service Address Utility Account Nu. <br /> Billing Address � � � Connection Permit Fee <br /> City,State, Zip _ Connection Fee <br /> Owner (Mortgagor) Total Fee <br /> Billing Name � <br /> Connection By <br /> Address _ _ Sipned <br /> - Customer " <br /> Phone__ <br /> DESCRI�TIDN: Sewer District <br /> Lot <br /> Block_ Monthly Sewer Service <br /> Division or Addition Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Remarks: CG�p!`TFD /a�/ �-��6 — SE�t <br /> � � Abutting Lot Line <br /> 5•�,�7 h' A7T,Ar'//tD 7a /�/'/i7iT �z i�C� PJ, S, E. W it. <br /> -- Aaproved By <br /> � Ciry Engincer <br /> ISSUBd DY <br /> / i ,,/ <br /> _ Inspe�tion By1( '� ��r'�� �""�"" <br /> ` .. <br /> e _ �9ate !nspected_ /o /z�j,� <br /> . <br /> SEESKETCH ATTACHED Nn. <br /> I��S�?�rTICi1 <br /> .--a <br />